I have received my blood results from my Doctor and can not understand them. The results are dated back from nine years ago. I asked a friend who has a Doctor as a Husband but he would not tell me what they mean as he said I would not understand them. She said my condition will only get worse in time and this has not put some fear into me. I am also waiting for a blood result as I may have too much iron in my blood. Can someone help me to understand these results as it is of no use to me if I do not understand what my results mean.
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Summerage11
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These are all under a title called value. Not sure if this is where I should be reading for results. There are so many more results for liver, urea and electrolytes and thyroid function
I am on two tablets per day, each tablet is 25mcg, I cant remember exactly when my headaches started, I have had them for several years.t I have just came off Vitamin D after a year, should I be tested for Vitamin d every year. I have never had a scan done regarding my throat.
Test done on the 17/12/2018, my thyroid function test as shown
Description Free T4 value 14.9 Normal Range 9-24 Units pmoI/L
You are undermedicated, you need a dose increase, 25mcg now, retest in 6 weeks, maybe another increase of 25mcg then, and retest 6 weeks later, and continue until your levels are where they need to be for you to feel well.
The aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well.
However, for a full picture we need
TSH
FT4
FT3
Thyroid antibodies
All vitamins and minerals need to be optimal for thyroid hormone to work properly.
Vit D is recommended to be 125nmol by the Vit D Council and 100-150nmol by the Vit D Society. You should retest Vit D now, and if you've reached the recommended level you need to find your maintenance dose to keep it there, which may be 2000iu daily, maybe more, maybe less, maybe more in winter than summer, it's trial and error. Retest twice a year to check level, you may need to do this privately as doctors tend not to repeat Vit D test.
Thank you for your advice, I do take 2 tablets each tablet is 25mcg so that will be 50mcg. The Doctor said I was fine at that, I did say that I do not feel any different. I have not been tested for FT3 or for anything that you have mentioned. Are those results ok or are they low. Sorry about this but I simply do not have a clue about anything.
I know you take 2 x 25mcg tablets, you said in an earlier post and I understood that, and I said you are undermedicated. 50mcg daily is a very small dose, it's a starter dose. An average dose is around 150mcg.
The Doctor said I was fine at that, I did say that I do not feel any different
You are not fine. Your TSH is too high. Your doctor is saying you are fine purely because your results are within the ranges. However, it's where in the range that is important, and where in the range that makes us feel well.
Are those results ok or are they low.
TSH is too high, FT4 is too low.
As I said before, the aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well.
If you still have symptoms of hypothyroidism - you can find those here
then print that list and tick all symptoms that you experience. Then take that list to your doctor and ask for an increase of 25mcg Levo. To support this take a copy of an article written by Dr Toft, past president of the British Thyroid Association and leading endocrinologist, which was published in Pulse Magazine (the magazine for doctors):
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.
You can obtain a copy of the article by emailing Dionne at
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor.
You can also refer your GP to Leeds NHS Teaching Hospital website here
Thyroxine Replacement Therapy in Primary Hypothyroidism
TSH Level .......... This Indicates
0.2 - 2.0 miu/L .......... Sufficient Replacement
> 2.0 miu/L Likely .......... under Replacement
**
I have not been tested for FT3 or for anything that you have mentioned.
If your doctor can't or wont do those tests, you can get them done privately with one of our recommende labs. Fingerprick tests are available, or venous blood draw is an option at extra cost. Either of the following tests cover everything mentioned:
It's worth noting that Levothyroxine must be taken in a certain way:
* Take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee, milk, etc, and water only for an hour either side, as absorption will be affected.
* Take any other medication and supplements 2 hours away from Levo, some need 4 hours.
Also, when booking thyroid tests, we advise:
* Book the first appointment of the morning. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.
* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.
* Leave off Levo for 24 hours before blood draw, if taking NDT or T3 then leave that off for 8-12 hours. Take after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
These are patient to patient tips which we don't discuss with doctors or phlebotomists.
Thank you for all this advice, I could not understand why the Doctor would tell me that all was normal when I never felt ok. I felt depressed and very often thought I was going mad as I felt alone on this as I did not know how to change anything or talk to someone with the same condition. My gran was over active but I did not know this until a few years ago. Thank you again for all your support and advice and have started to take my medication at night, very grateful.
Look at the ranges alongside each result. Add in here any results that are in bold or marked out in some way - any that are outside the 'normal' range given.
How do you take your Levothyroxine presently? Do you take it on its own, with water only and wait at least one hour before having any food or drink? Are you on any other medication or taking any supplements?
To be honest, if the results are 9 years old, there isn't any use talking about them, they'll likely have no bearing on your situation today. You haven't said if you are taking medication, or what your symptoms are, or how you feel, which is more relevant to now; and if are still symptomatic, you should either ask your GP to retest in addition to your latest iron tests, or do what so many of us do, which is to have a comprehensive set of tests privately and then post those for comment.
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